New here

[Kat]

Hi! I'm a 37 year old Canadian woman and I have two copies of APOE e4. I'm looking into ways to best prevent AD.

I'm new to this forum (although I've been reading about some topics for a couple of weeks now).

My particular question today is about diet. I've looked at the ReCode program from Dr. Bredesen. I feel like I'm seeing a lot of mixed information about what is best in terms of diet as I have also seen Dr. Ornish's clinical trial indicating that a diet that is completely plant-based and higher in complex carbohydrates is best: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157928/

I feel like Dr. Ornish's findings may be more accurate because one of the criticisms of Dr. Bredesen's protocol is that there hasn't been a clinical trial of it and it is essentially assertions he is making based on anecdotal information. That said, I've read a lot of good things about Dr. Bredesen's protocol on this forum.

I was just wondering what other people's thoughts are on the Ornish vs Bredesen diets.

Thank you!

[Laurie Sotro]

Hi! I'm a 37 year old Canadian woman and I have two copies of APOE e4. I'm looking into ways to best prevent AD.

I'm new to this forum (although I've been reading about some topics for a couple of weeks now).

My particular question today is about diet. I've looked at the ReCode program from Dr. Bredesen. I feel like I'm seeing a lot of mixed information about what is best in terms of diet as I have also seen Dr. Ornish's clinical trial indicating that a diet that is completely plant-based and higher in complex carbohydrates is best: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157928/

I feel like Dr. Ornish's findings may be more accurate because one of the criticisms of Dr. Bredesen's protocol is that there hasn't been a clinical trial of it and it is essentially assertions he is making based on anecdotal information. That said, I've read a lot of good things about Dr. Bredesen's protocol on this forum.

I was just wondering what other people's thoughts are on the Ornish vs Bredesen diets.

Thank you!

Hello Kat,

My name is Laurie and as a Support Team Intern, I would like to welcome you to this forum; we are so glad you joined us! You have found a very informative and supportive community.

I commend you for taking some time these past couple of weeks and checking things out here; you clearly have a high level of curiosity along with a love of learning. These character strengths will really help you along this journey of AD research and prevention. And I would like to encourage you on that journey, because you most certainly can prevent AD! Thank you for sharing the NIH article, an excellent resource.

As you know, one of the most important life style factors mentioned in the article is diet and nutrition. The question you pose regarding a comparison with Dr. Ornish and Dr. Bredesen's plans, is a great one! But as you also know, there may not be an easy answer. One thing I appreciate about Dr. Bredesen, is that he does see people as having the wisdom and ability to make choices that work for them. As a forum, we cannot recommend one plan over another because each person and their biological make up is so unique. You may already have a strong sense of whether a plant-based or animal-based diet is right for you. Do you notice that you naturally feel better or perform better on one versus the other? I think the term "bio-individuality" says it best... there is no single right plan that fits the needs of everyone. Please continue your deep dive into studies and research until you find the nutrition plan that feels right for YOU! Follow your gut on this (no pun intended) and you will find the perfect plan for your cognitive health and longevity.

You may have already discovered the info contained within both the Wiki and also the Primer , which is a detailed and informative resource written by a practicing M.D. with ApoE4/4. But I thought I would include these links here for you just in case.

You may also be interested in learning about other member's journeys or even sharing your own story with us, and we welcome you to do so! The encouragement and support found in these stories are some of our members favorite things to read through. If you haven't already checked it out, feel free to take a look with this link:
Our Stories.

In closing, please know having two copies of Apoe4 does not determine your future! As you get to know others here in this forum you will see person after person living incredible lives well into their 70's, 80's and beyond!! Starting your journey at the age of 37, sets you up for success in cognitive health and longevity!
Again, welcome! Please let us know if we can be of any further assistance.

Kindly,
Laurie Sotro
Support Team Intern

[lana_banana]

My particular question today is about diet. I've looked at the ReCode program from Dr. Bredesen. I feel like I'm seeing a lot of mixed information about what is best in terms of diet as I have also seen Dr. Ornish's clinical trial indicating that a diet that is completely plant-based and higher in complex carbohydrates is best: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157928/

Hi Kat - welcome to our forum. Always good to see a fellow Canadian around! As you explore our resources, I want to flag a few things that might be helpful in answering this question.

First, a Youtube channel called Nutrition Made Simple did a nice overview of the recent Ornish study and its findings here: https://www.youtube.com/watch?v=YjKLf-9U2hc The presenter is a physician (and - if I recall correctly - also a Ph.D in nutrition) and I've always found him to be thoughtful and accurate in his discussion.

Second, there's a paper called Precision Nutrition for Alzheimer's Prevention that provides nutrition recommendations for APOE4 carriers. It lays out the existing science, identifies where there are gaps in human research, and explains plausible mechanisms for its recommendations where no clinical data exists. You can give it a read here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073598/

Best of luck in your research!

[TheresaB]

I feel like Dr. Ornish's findings may be more accurate because one of the criticisms of Dr. Bredesen's protocol is that there hasn't been a clinical trial of it and it is essentially assertions he is making based on anecdotal information. That said, I've read a lot of good things about Dr. Bredesen's protocol on this forum.

Welcome to the ApoE4.info community Kat. Thank-you for sharing that interesting paper.

Something you've been misinformed about however. There has been a clinical trial of Dr Bredesen’s protocol. Here's an article about trial:
Evidence That Early Alzheimer’s Can Be Reversed
and the paper itself:
Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project.
There are also other papers showing success utilizing Dr Bredesen's protocol. Plus I would hardly call Dr Bredesen’s decades of neurological research and over 200 published peer-reviewed papers as "anectotal". Dr Bredesen certainly has published more papers that includes a discussion on APOE4 than Dr Ornish. Google scholar lists none for Dr Ornish, whereas you can see the list of Dr Bredesen’s from ourApoE4.info wiki on the Bredesen Protocol here: https://wiki.apoe4.info/wiki/Bredesen_P ... 27s_Papers.

Neither trial is perfect, both have limitations. Both consisted of a small cohort and both lasted a very short time compared to a disease that develops over decades.

Interestingly, there’s a fair amount of overlap between the two, Bredesen’s is plant rich whereas Ornish’s is plant exclusive and both emphasize stress management, exercise, and certain supplements.

What I prefer about Dr Bredesen’s protocol is it extends beyond that and is a targeted/individualized approach. For example, one person’s cognition issues may be driven by inflammation versus another may be toxic in origin and Dr Bredesen's protocol is adjusted acordingly. My skimming of Dr Ornish’s paper didn’t indicate a precision approach.

And while APOE4s have unique biological differences compared to non-carriers, in my personal, humble opinion, there is/will never be one APOE4 diet, much less a singular Alzheimer’s treatment/prevention diet, because we all have other genes, ethnic/ancestral backgrounds, geographical living conditions, males and females have different hormonal responses, etc.

[Kat]

Hi Theresa,

Thank you so much for this info! I can definitely see what you mean about there being overlap in that primarily vegetable based diets seem to be the way to go. It makes a lot of sense that diets would need to be individualized. I can’t see doing an entirely plant based diet because I adore fish. I’m nervous about starting the ketogenic diet because I’m worried that if I don’t adhere to it perfectly but follow it 90% of the time that I may be doing more harm than good.

Do you know if there are any tests that can be done to help determine the ideal diet based on genes/ethnicity/geography/sex?

I’m used to a fairly balanced diet as far as carbs/fats/proteins are concerned (I don’t eat red meat or processed foods, but cheese is a downfall). I’ve feel fine I think which is why I’m not sure what to do in terms of changes other than definitely incorporating more vegetables and eliminating simple carbs.

Also, I read somewhere recently that vegetables in the nightshade family may increase inflammation. I’m wondering if these are regularly avoided by APOE 4 carriers.

Thank you again for your help!

[Kat]

Hi Laurie,

Thank you so much for your message and for all of that information!

There is so much to take in and learn. It has been a bit of an overwhelming journey so far but finding this group has been amazing.

Thank you for sharing all of those resources and I’m excited to be a part of this community!

[Kat]

Hi Lana,

Thank you so much for this info! I watched that video and it makes a lot of sense. Also thank you for attaching that article! I’d seen the abstract of it online but couldn’t find a way to access the whole article, I’m so glad to have read it now.

Very keen to follow further developments in research about diet and other lifestyle factors that can help us.

Thanks again,

Kat

My particular question today is about diet. I've looked at the ReCode program from Dr. Bredesen. I feel like I'm seeing a lot of mixed information about what is best in terms of diet as I have also seen Dr. Ornish's clinical trial indicating that a diet that is completely plant-based and higher in complex carbohydrates is best: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11157928/

Hi Kat - welcome to our forum. Always good to see a fellow Canadian around! As you explore our resources, I want to flag a few things that might be helpful in answering this question.

First, a Youtube channel called Nutrition Made Simple did a nice overview of the recent Ornish study and its findings here: https://www.youtube.com/watch?v=YjKLf-9U2hc The presenter is a physician (and - if I recall correctly - also a Ph.D in nutrition) and I've always found him to be thoughtful and accurate in his discussion.

Second, there's a paper called Precision Nutrition for Alzheimer's Prevention that provides nutrition recommendations for APOE4 carriers. It lays out the existing science, identifies where there are gaps in human research, and explains plausible mechanisms for its recommendations where no clinical data exists. You can give it a read here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073598/

Best of luck in your research!

[Kat]

Hi Theresa,

Thank you so much for this info! I can definitely see what you mean about there being overlap in that primarily vegetable based diets seem to be the way to go. It makes a lot of sense that diets would need to be individualized. I can’t see doing an entirely plant based diet because I adore fish. I’m nervous about starting the ketogenic diet because I’m worried that if I don’t adhere to it perfectly but follow it 90% of the time that I may be doing more harm than good.

Do you know if there are any tests that can be done to help determine the ideal diet based on genes/ethnicity/geography/sex?

I’m used to a fairly balanced diet as far as carbs/fats/proteins are concerned (I don’t eat red meat or processed foods, but cheese is a downfall). I’ve feel fine I think which is why I’m not sure what to do in terms of changes other than definitely incorporating more vegetables and eliminating simple carbs.

Also, I read somewhere recently that vegetables in the nightshade family may increase inflammation. I’m wondering if these are regularly avoided by APOE 4 carriers.

Thank you again for your help!

I feel like Dr. Ornish's findings may be more accurate because one of the criticisms of Dr. Bredesen's protocol is that there hasn't been a clinical trial of it and it is essentially assertions he is making based on anecdotal information. That said, I've read a lot of good things about Dr. Bredesen's protocol on this forum.

Welcome to the ApoE4.info community Kat. Thank-you for sharing that interesting paper.

Something you've been misinformed about however. There has been a clinical trial of Dr Bredesen’s protocol. Here's an article about trial:
Evidence That Early Alzheimer’s Can Be Reversed
and the paper itself:
Precision Medicine Approach to Alzheimer’s Disease: Successful Pilot Project.
There are also other papers showing success utilizing Dr Bredesen's protocol. Plus I would hardly call Dr Bredesen’s decades of neurological research and over 200 published peer-reviewed papers as "anectotal". Dr Bredesen certainly has published more papers that includes a discussion on APOE4 than Dr Ornish. Google scholar lists none for Dr Ornish, whereas you can see the list of Dr Bredesen’s from ourApoE4.info wiki on the Bredesen Protocol here: https://wiki.apoe4.info/wiki/Bredesen_P ... 27s_Papers.

Neither trial is perfect, both have limitations. Both consisted of a small cohort and both lasted a very short time compared to a disease that develops over decades.

Interestingly, there’s a fair amount of overlap between the two, Bredesen’s is plant rich whereas Ornish’s is plant exclusive and both emphasize stress management, exercise, and certain supplements.

What I prefer about Dr Bredesen’s protocol is it extends beyond that and is a targeted/individualized approach. For example, one person’s cognition issues may be driven by inflammation versus another may be toxic in origin and Dr Bredesen's protocol is adjusted acordingly. My skimming of Dr Ornish’s paper didn’t indicate a precision approach.

And while APOE4s have unique biological differences compared to non-carriers, in my personal, humble opinion, there is/will never be one APOE4 diet, much less a singular Alzheimer’s treatment/prevention diet, because we all have other genes, ethnic/ancestral backgrounds, geographical living conditions, males and females have different hormonal responses, etc.

[TheresaB]

Do you know if there are any tests that can be done to help determine the ideal diet based on genes/ethnicity/geography/sex?

Traditional doctors are given very little instruction on nutrition, I’ve heard that if a doctor receives any nutritional training, it was an elective.

To best target my needs, I visited a Functional Medicine Doctor, (used to be a traditional doctor, so still a trained MD). He took a panel of blood tests to determine areas of insufficiency, sensitivity, etc.

Something you may want to consider is this: https://www.functionhealth.com/ 100 lab tests, functional approach, $499.

What the doctor advised me to eat may be different than you, but his general recommendations included a polyphenol rich diet (a variety of certain fruits, vegetables, Extra Virgin Olive Oil). Nightshades are very inflammatory in me (I too felt fine, but that’s not what my blood tests showed). My doctor recommends limiting all foods high in lectins since APOE4s are pro-inflammatory.

Dairy is inflammatory for most people.

Foods with gluten activates zonulin and contributes to leaky gut which in turn leads to permeable blood brain barrier (another health weakness of APOE4s) which drives neuroinflammation, so I avoid all grains. I eat a plant rich diet, but try to keep it down to those low in carbohydrates to maintain insulin sensitivity, another important need of APOE4s especially.

With testing, by doctor also identified certain foods where I have food sensitivities and need to avoid.

Fish is very good for ApoE4s. Large fish should be avoided since they are at the top of the food chain, and tend to have the highest levels of mercury. However, the grouping of fish called SMASH fish (Salmon, Mackerel, Anchovy, Sardine, Herring) and shellfish (shrimp [preferably wild-caught], crab [preferably wild-caught], mussels, clams, oysters) and fish roe (fish eggs) are especially beneficial with high levels of Omega-3s, specifically phospholipid DHA, which according to Dr Rhonda Patick is especially beneficial for APOE4s since we have impaired free DHA uptake. There are papers supporting positive connections in slowed cognitive decline and greater longevity in APOE4s with greater fish consumption.

Adequate (not too much, not too little) protein is also important (especially with age) and hard on a strictly vegan diet while also balancing healthy insulin and blood glucose levels. My husband (who holds one 4) was vegetarian for years and after maintaining that diet for such an extended period of time, developed insulin resistance, fortunately he caught it early. He/we still eat a lot of varied plant foods, but not exclusively.